Organization
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Active
Organization
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Active
Parent organization
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Other names
NortheastFloridaStateHospitalCommunityBehavioralHealthcareServices
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Authorized official
MRS. TONIA KAY BRANCH LMHC,NCC,CAP (OPERATIONS CONSULTANT MANAGER)
(904) 259-4671
Entity
Organization
Contact information
Practice address
84 W LOWDER ST STE C, MACCLENNY, FL 32063-2638
(904) 259-4671
(904) 259-5187
Mailing address
84 W LOWDER ST STE C, MACCLENNY, FL 32063-2638
(904) 259-4671
(904) 259-5187
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
FL
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070483100
—
FL
05
—
910220500
—
FL
Enumeration date
10/25/2006
Last updated
07/21/2022
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